Avaliação da lipoproteína de alta densidade em pacientes com doença renal crônica em terapia substitutiva: antes e após o trasnplante renal

Abstract

Chronic kidney disease (CKD) is a worldwide relevant public health problem, with early cardiovascular disease (CVD) as the most cause of death. Disorders in lipoprotein metabolism are associated with CVD increasing, which makes it imperative to advance in lipoprotein structure and functionality studies, especially for high-density lipoprotein (HDL), as it acts in the reverse cholesterol transport and has cardioprotective, antioxidant, and anti-inflammatory properties, very important aspects in patients with CKD. This study aimed to evaluate HDL structural modifications in patients with CKD undergoing renal replacement therapy (RRT), hemodialysis, before and after kidney transplantation. This study included 50 patients with CKD undergoing hemodialysis before and after four months of kidney transplantation. Biochemical analyses were performed by reflectance, HDL particle size, and polydispersity by the light scattering method and the Apo-AI and Apo-B by turbidimetry. Significant increases were found among total cholesterol, non-HDL cholesterol, and LDL-c concentrations after transplantation. For Apo-B and the ApoB/Apo A-I ratio, we observed a significant increase after transplantation only in men. C-reactive protein was significantly lower after transplantation. No significant differences were found in HDL particle size before and after kidney transplantation. However, when analyzing the HDL particles polydispersities, the dispersion was lower after transplantation. The study findings showed significant differences in lipid metabolism before and after kidney transplantation. To properly assess the findings and their possible influence as a condition that increases cardiovascular risk, it will be necessary to develop more in-depth HDL structure and functionality studies, mainly considering the type of study design to reach the appropriate goals intended to be evaluated.